Healthcare Provider Details

I. General information

NPI: 1184436255
Provider Name (Legal Business Name): MR. ENOC RAMIREZ LEGARRETTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 4 BOX 30500
HATILLO PR
00659
US

IV. Provider business mailing address

HC 4 BOX 30500
HATILLO PR
00659
US

V. Phone/Fax

Practice location:
  • Phone: 787-597-2333
  • Fax:
Mailing address:
  • Phone: 787-597-2333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number8249
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: